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This is VAERS ID 1350397

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1350397
VAERS Form:2
Age:69.0
Sex:Female
Location:Unknown
Vaccinated:2021-05-22
Onset:2021-05-22
Submitted:0000-00-00
Entered:2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0186 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Erythema, Pruritus, Rash, Peripheral swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of Cardiac catherization (angiogram) through right arm
Allergies:
Diagnostic Lab Data: Pulse: 91 bpm Respiration: 18 SPO2: 97% B/P 140/78 Exam: normal
CDC 'Split Type':

Write-up: AE: Patient started feeling itchy on the arms, redness and swelling in the right forearm seen 28 minutes after vaccination. Tx: n/a, water improved rash outcome: patient rash improved spontaneously without medication. patient was discharged home.

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